Home Emergency Care Topic of the Month

When a medical emergency occurs, the city of Waitsburg and its surrounding homes and farms face challenges, as do all rural areas, in EMS response times and transport times to an emergency room. This monthly column, written by former firefighter and paramedic Randy Charles, is aimed at providing area residents, who are faced with a medical or traumatic event, some knowledge and skills that can be utilized to help a stricken individual while waiting for EMS.

OVERVIEW

Uncontrolled bleeding (hemorrhage) is the number one cause of preventable death from trauma. There are different types of bleeding depending on what type of blood vessel(s) are involved but there is one common approach to effectively stop bleeding and that is to compress the blood vessels that are punctured, or severed, by firm steady application of pressure on the wound aimed at compressing the injured blood vessel.

Please note that there is a free nation-wide education and training program entitled “ STOP the BLEED,” more info is available at Bleedingcontrol.org. It’s a great program offering complete training on how to effectively stop a bleed after an injury. I encourage everyone to take this course or at least read their free materials.

TYPES OF BLEEDING

Depending on the type of blood vessel(s) involved with the bleeding and the location of the bleeding, you will need to do some variation of the application of pressure.

If the bleeding is slow and oozing out it is likely from very small blood vessels(capillaries).

If it is more of a flow and the blood is a darker red (not bright red), but is not spurting out, it is from a larger vein.

If the bleeding is spurting from the wound with noticeable force and is a brighter red, it is from a severed or punctured artery and this requires more intense treatment in order to be controlled.

STEPS TO TAKE TO CONTROL THE BLEEDING

MINOR

If the injury is causing a minor bleed as a result of an abrasion or minor laceration, it is bleeding from capillaries or a small vein:

Flush the wound to clean it

Apply a thin layer of antiseptic cream/ointment and a sterile dressing and bandage

Monitor for signs of infection (hot skin around the wound, continued swelling and redness, draining fluids from the wound…)

MORE SEVERE

If the bleeding is more severe and flowing (not spurting):

Apply a sterile bandage (if a sterile bandage is not readily available use a clean cloth or rag) to the wound site

Apply direct pressure over the wound

Elevate the limb if possible

Call 911 or take patient immediately to a medical facility.

VERY SEVERE

An arterial bleed or any deep laceration or puncture, or a partial or complete amputation of an arm or leg is life threating:

Call 911 immediately. Remember that a severed artery can cause death very quickly.

Apply direct pressure with a sterile or clean cloth if available (if none is available use your hand).

It will require significant pressure when an artery is the source of the bleeding.

Use 2-3 fingers (not the palm of your hand) and press down just above the wound itself or in the wound itself to close the severed artery. This will be painful to the patient, but it is necessary to stop the bleeding and save his/her life.

If the bleeding continues despite the application of pressure, or you can not physically continue to apply effective pressure, then it is time to use a tourniquet … if the wound is on a leg or arm.

Use either a commercially available tourniquet or a wide belt, etc. Avoid use of narrow belts, ropes, or shirt.

Apply the tourniquet 2-3 inches above the wound.

This also will be painful but continue to tighten the tourniquet until the bleeding is stopped.

If the wound is just below a joint then apply the tourniquet immediately above the joint.

Do not release the tourniquet. Make a note of the time the tourniquet was applied.

Note the use of tourniquets is now an accepted practice in such situations.

Remember that even if you control the bleeding from a relatively minor injury it is also advisable to seek medical care. The wound may need sutures to heal properly and the patient may need a Tetanus shot or booster and or an antibiotic to avoid infection.

All homes and businesses should have a first aid kit available that includes sterile dressings, bandages, antibiotic cream/ointments, and a tourniquet. You can purchase complete kits commercially or put your own together. The Stop the Bleed website is a good reference for assembling your home or business kit.